Presentation on theme: "First Aid and On- the-Field Evaluation Athletic Medicine I."— Presentation transcript:
First Aid and On- the-Field Evaluation Athletic Medicine I
Objectives Know the difference between a primary and secondary survey Know the components of an Emergency Action Plan Know the signs/symptoms of shock and how it is treated
Bloodborne Pathogens We need to protect ourselves from potential harmful situations. Bloodborne pathogens are pathogenic microorganisms that can cause disease (viruses). Hepatitis B (HBV) Hepatitis C (HCV) Human immunodeficiency virus (HIV)
Modes of Transmission Bloodborne pathogens are transmitted through the following: Human blood Semen Vaginal secretions Cerebrospinal fluid Synovial fluid
Universal Precautions The Occupational Safety and Health Administration (OSHA) has established standards for people to follow to reduce their risk of contracting a virus. If an athlete has any open wounds or lesions, they should be covered prior to participation. If an athlete is bleeding during competition, they must be removed and treated by the medical staff.
The Bleeding Athlete If there is a potential to come into contact with bloodborne pathogens, we must use appropriate protection (aka gloves). When we are done dealing with the athlete, we must either wash our hands or use hand sanitizer. Must dispose of saturated materials in a biohazard bag.
Emergencies Most sports injuries do not result in life-or-death emergency situations, but when they do arise, prompt care is essential. Time is a critical factor; no room for uncertainty, indecision, or error. If you make a mistake, it can create a life-threatening situation.
Emergency Action Plan An Emergency Action Plan dictates how each emergency situation should be handled (i.e. cardio- respiratory distress, c-spine injury, open fracture, asthma attack). The key to emergency aid is the evaluation of the patient.
Emergency Action Plan Must have the following: Emergency Personnel Emergency Communication Emergency Equipment Roles of First Responders Activation of EMS Venue Directions
Principles of On-the-Field Assessment On-the-Field Assessments helps determine the nature of the injury and provides direction in the decision-making process concerning emergency care. Divided into primary survey and secondary survey.
Primary Survey Done initially Determines the existence of potentially life-threatening situations. Problems with level of consciousness Airway Breathing Circulation Severe bleeding Shock
Unconsciousness Many causes Must treat as life-threatening 1.ABCs 2.C-spine stabilization Must pay attention to how they are positioned: Supine: on their back Prone: on their front
Treating an Unconscious Athlete Supine and Breathing Monitor closely until EMS arrives Supine and Not Breathing CPR Prone and Breathing Monitor closely until they regain consciousness Roll onto spine board Prone and Not Breathing Logrolled and CPR started
Unconscious Athlete: Equipment IF A FOOTBALL PLAYER IS SUSPECTED TO HAVE A C-SPINE INJURY, WE NEVER EVER EVER EVER REMOVE THE FOOTBALL HELMET…unless it doesn’t fit properly. Facemask removed
Bleeding Hemorrhage: The abnormal discharge of blood. Three sources Arterial Venous Capillary What is the first thing we do when dealing with a bleeding athlete? PUT GLOVES ON!!!!!!!!!!!!!!!!!!!!!!!
External vs. Internal Hemorrhage External Controlled through direct pressure, elevation, and pressure points. Internal Invisible to the eye Subcutaneous, intramuscular, within a joint Within body cavity: LIFE OR DEATH Can result in shock Hard to detect
Shock Most commonly occurs with severe bleeding, fractures, or internal injuries. Occurs when a diminished amount of blood is available to the circulatory system.
Shock Signs/Symptoms Low blood pressure Rapid and weak pulse Drowsy/sluggish Breathing is shallow and rapid Skin is pale, cool, and clammy
Shock Treatment Maintain body temp. Elevate the feet and legs approximately 8-12 inches. Keep the athlete lying down. Do not let them look at the injury. Nothing should be given by mouth.
Types of Shock Hypovolemic: Blood loss. Respiratory: Lungs are unable to supply enough oxygen (collapsed lung). Psychogenic: Temporary dilation of blood vessels (causes fainting). Cardiogenic: Inability of the heart to pump enough blood. Septic: Caused by severe bacterial infection. Anaphylactic: Result of severe allergic reaction. Metabolic: Severe illness goes untreated or there is an extreme loss of body fluid.
Secondary Survey After it is determined that there are no life-threatening injuries, we can start the secondary survey. Takes a closer look at the injury.
Recognizing Vital Signs Level of consciousness Pulse Respiration Blood pressure Temperature Skin color Pupils Movement
Level of Consciousness AVPU scale Alert: awake, responsive to voice, and oriented. Verbal: Patient responds to voice but is not fully oriented to person, time, or place. Pain: Patient does not respond to voice, but does respond to painful stimulus. Unresponsive: Does not respond to painful stimulus.
Pulse Use carotid artery (neck) or radial (wrist). Normal is 80-100 beats/minute. Conditioned athletes may have lower resting pulse rate. Take into consideration their workout status. Rapid/weak= shock, bleeding, diabetic coma, heat exhaustion Slow/strong= skull fracture or stroke Rapid/strong= heatstroke
Respiration Normal 12-20 breaths/minute Shallow breathing= shock Frothy blood= chest injury affecting the lungs
Blood Pressure Checked with a sphygmomonometer. Systolic/diastolic Systolic BP is the pressure in the arteries when the heart is beating Diastolic BP is the pressure in the arteries when the heart is at rest Normal 100-120/70-80 (females usually have lower BP) Low BP= hemorrhage, shock, heart attack, or internal injury.
Temperature Normal 98.2-98.6°F Thermometer should be placed under the tongue, in the armpit, against the tympanic membrane Hot/dry skin= disease, infection, overexposure to heat Cool/clammy skin= shock, trauma, heat exhaustion
Skin Flushed or red color can mean heatstroke, sunburn, allergic reaction, high BP, or elevated temperature. Pale, ashen, or white skin can mean insufficient circulation, shock, fright, hemorrhage, heat exhaustion. Yellow skin indicates liver disease or dysfunction.
Pupils Some people naturally have anisocoria (unequal pupils) If one or both pupils are dilated, the patient may have sustained a head injury; may be experiencing shock, heatstoke, or hemorrhage. If one or both pupils fail to accommodate to light, there may be brain injury. Reaction to light is more important than size.
Movement Inability to move a body part can indicate a serious CNS injury. When it affects one side, it could be caused by head injury or stroke. Bilateral tingling and numbness or sensory or motor deficits of the upper extremity may indicate a C-spine injury.
Skin Wounds Abrasion: Skin is rubbed against a rough, hard surface (i.e. road rash, turf burn) Incision: Caused by a sharp object. Laceration: Has jagged edges; usually caused from machinery. Puncture: Small hole caused by long, sharp, pointy object. Avulsion: Partial, or complete tearing away of tissue and/or skin.
Musculoskeletal Evaluations How do we decide if an athlete can return to the game or practice after getting hurt? Evaluations need to be quick. Musculoskeletal injuries include: Fractures Contusions (bruises) Sprains Strains
Observation Going to look for any obvious deformity. If no obvious deformity, move on with eval.
Mechanism Mechanism of Injury: Mechanical description of the cause of injury (i.e. inversion) Gather detailed history of the events leading up to and immediately following injury. What did you hear/feel? Popping, snapping, and/or cracking can indicate a fracture.
Observation Note any swelling and discoloration.
Palpation Feeling the injured area for deformity, edema, excess heat. Also feeling for crepitus (crunching), which is related to a fracture.
Immediate Treatment The goal of immediate treatment is to reduce edema and control hemorrhage.
RICE Rest: Few days off of sports the rest the injury. Ice: 20 minutes of ice/1 hour off Compression: Ace wrap to control edema Elevation: Above the heart
REST The healing process is started immediately after injury. Usually, 72 hours of rest is recommended.
ICE Ice decreases pain (analgesic), slows hemorrhage, and controls edema. 20 minutes of ice is recommended for deep structures; 10-15 for superficial. If someone is going to use an ice bath or bucket, ~12 minutes is recommended.
COMPRESSION Immediate compression is as essential as immediate cold application. Helps keep hemorrhage and edema down. Should be worn for 72 hours.
ELEVATION Eliminates the effect of gravity on edema. Assists in draining fluids from the area. Elevation should occur for 72 hours following injury.
Poster With a partner you will make 2 posters. One poster will be about the immediate treatment of musculoskeletal injuries (RICE). One poster will be about skin wounds. Each poster should contain pictures and descriptions. R=Rest; usually athletes rest for 72 hours following injury Abrasion: Superficial skin would usually caused by rubbing against a hard, rough surface.
Body Positioning (Supine vs. Prone) Breathing?Treatment